Orthopaedists and other physicians in Maine organized the Maine Medical
Assessment Foundation to deal with the problem of variations in the rates
of hospitalization for orthopaedic conditions. Five musculoskeletal
injuries and five orthopaedic procedures were selected for study. The
variation in decision-making by orthopaedists was least for fractures of
the ankle and fractures of the hip and was greatest for fractures of the
forearm, derangement of the knee, and lumbosacral sprain. The rates in an
area tended to be consistently high or low for the same treatments. The
major reasons for the variations appeared to be related to lack of
agreement about optimum treatment. Feedback of data to physicians on
variations in patterns of practice reduced the variations.